While Republicans rejoice over states like North Carolina that are refusing to set up state health care exchanges and refusing the Medicaid expansion, hospitals are quietly closing their doors. Especially hospitals who serve those who are mostly poor and don't have access to health care.

A small hospital in a coastal North Carolina community will close its doors within months and its parent company says Gov. Pat McCrory's (R) decision not to expand Medicaid under President Barack Obama's health care reform law is partly to blame.

Vidant Health, a nonprofit 10-hospital network, will shutter the 49-bed Vidant Pungo Hospital in Belhaven, about an hour's drive east of the chain's Greenville headquarters, within six months, the company announced this week. Other considerations, including outdated facilities, also led to the company's decision to close the hospital but North Carolina foregoing the Medicaid expansion contributed to the decision, Vidant Health CEO David Herman told The Huffington Post.

North Carolina is one of 26 states where Republican governors or state legislators have rejected the Medicaid expansion. The expansion is intended to provide health benefits to anyone who makes up to 133 percent of the federal poverty level, which is $15,282 for a single person this year.

As a result, the states will turn down billions of federal dollars and millions of poor residents in these states will remain uninsured even after Obamacare's coverage expansion takes full effect next year.

McCrory signed legislation in March blocking the Medicaid expansion and the creation of a state-run health insurance exchange in North Carolina, citing cost and other factors.

The hospital industry nationwide has lobbied state lawmakers and governors to adopt the Medicaid expansion as a way to reduce the burden of medical bills that go unpaid when poor patients can't afford their treatments. Nationally, hospitals provided $41.1 billion in so-called uncompensated care in 2011, according to the most recent data from the American Hospital Association.

This particular hospital serves 25,000 patients over a span of 1,260 square miles. While it only has 49 beds, it is the only hospital available to people in this area.

The news of its closure comes on the heels of news that the cost of insurance in states which have established exchanges is actually far lower than expected, even before the subsidies. With the subsidies, it drops even further.

But hey, North Carolina. You go ahead and pretend like emergency rooms are a reasonable alternative to people getting health care. Just don't expect us to weep for you when your people don't even have access to emergency rooms after they all close or the costs are passed on to paying patients in the form of wildly inflated prices for items like aspirin and saline solution. We might, however, shed a few tears for the people you killed.

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